Gastroenterology Blog

There are many changes that can occur within the digestive tract, particularly with age. One such change, which is increasingly common in patients over 40, is the development of small pouches within the digestive system’s lining, most often in the lower portion of the large intestine commonly referred to as the sigmoid colon. These bulging pouches are known as diverticula and their presence is a condition called diverticulosis or diverticular disease. In many cases, they cause no problematic symptoms. However, there are instances in which diverticulosis may progress into a condition known as diverticulitis.

What is Diverticulitis?

Diverticulitis occurs when diverticula tear and become infected, inflamed, or both.

What are the Symptoms of Diverticulitis?

The most common symptom associated with diverticulitis is pain and tenderness in the lower left abdomen. This pain could be sudden and severe or mild and progressing in intensity over a course of several days. Additional symptoms of diverticulitis can include:

Fever

Nausea and vomiting

Constipation (diarrhea is less common)

What are the Complications of Diverticulitis?

Most patients with diverticulitis will not experience complications. However, about 25 percent could experience one or more of the following:

Peritonitis, or abscess of the abdominal cavity which occurs when a perforation of diverticula allow contents of the intestine to seep out. Peritonitis is an emergency medical situation and could be fatal without prompt surgical intervention.

Who is Most Likely to Suffer from Diverticulitis?

Diverticulitis is more likely to occur with age and is most often seen in those over 40 years old. Additional risk factors for developing the condition include:

Being overweight

Eating a diet that is low in fiber and high in animal fats

Smoking

Taking medications such prescription or over-the-counter pain killers

Sedentary lifestyle

How is Diverticulitis Treated?

Most cases of diverticulitis respond well to antibiotics. Additionally, a physician may recommend a temporary liquid diet as the colon heals. However, patients who have complications associated with diverticulitis may require additional interventions. These could include draining of an abscess or surgery in the most severe cases.

If you are suffering from the symptoms of diverticulitis, do not delay seeking treatment. With the appropriate course of antibiotics and dietary changes, it is likely that your case will resolve without complication. Contact Gastroenterology Associates and request an appointment with one of our board-certified gastroenterologists today.

In some individuals, marble-sized pouches known as diverticula form in the digestive tract, most commonly in the colon. Diverticula can develop at any age and are not uncommon. In fact, most people who develop these pouches have no symptoms as long as nothing goes wrong. However, if one of the diverticula becomes infected or inflamed, then a range of bowel problems may occur.

Diverticulosis is the presence of diverticuli, mostly without symptoms. If infection occurs, only then is it called diverticulitis. If you were told that you had diverticuli at the time of your colonoscopy, it is diverticulosis, not diverticulitis, as most people get these terms confused.

Causes

The exact cause of the development of diverticula is unknown. Studies have linked it to a low-fiber diet, and scientists theorize that lack of fiber causes the intestines to work harder to move feces through the system. Increased pressure resulting from this harder work may, over time, cause diverticula to develop in weak spots throughout the digestive tract. There are several factors associated with a higher risk of diverticulitis:

Age of 40 or higher

Obesity

Smoking

Low-fiber diet

Sedentary lifestyle

Diverticulitis is infection or inflammation of the diverticula. As with diverticula as a whole, there is still some speculation as to the exact causes. It's possible that increased pressure weakens the walls of the diverticula, leading to infection. If fecal matter enters the diverticula, infection can also occur. If the opening of a diverticula becomes obstructed, its blood supply can be restricted, leading to inflammation.

Symptoms

Symptoms of diverticulitis usually occur relatively quickly. They may persist for anywhere from a few hours to longer than a week. Patients may experience one or more of the following:

Pain and tenderness in the abdomen, usually the left side

Nausea and vomiting

Constipation

Fever

Loss of appetite

Bloating and gas

Sudden changes in bowel habits

Although it is not common, it's possible for diverticulitis to lead to serious complications. For example, an infection in a diverticula has the potential to lead to an abcess, an infection throughout the abdominal cavity, or even an infection throughout the body. Severe cases can cause the formation of a fistula or even a bowel obstruction. Rarely, a hole may form in the colon, allowing stool to enter the abdominal cavity. For these reasons, diagnosis and treatment is essential.

Sometimes, significant bleeding may result from the diverticuli. Since these symptoms can mimic those of other bowel conditions, your doctor will use diagnostic tests, such as blood samples and medical imaging, to determine the exact cause of your symptoms.

Treatment

The exact course of treatment depends on the severity of your symptoms and whether or not you have an infection. Mild cases can often be treated with non-steroidal anti-inflammatory drugs like Tylenol, heating pads, and relaxation. Infections will be treated with antibiotics. If your symptoms are severe and recurrent or have caused complications, or if your diverticulitis has not responded to past treatments, then it may be necessary to surgically remove the diverticula. Sometimes further evaluation may be necessary to rule out any obstruction that may contribute to diverticulitis (by a colonoscopy).

Taking lifestyle changes to promote bowel health is important for all people, but those with a history of diverticulitis can especially benefit from eating a healthy diet, drinking plenty of water, and exercising regularly.

It is important to see your physician when you have symptoms, especially if recurrent, suggestive of diverticulitis to confirm the diagnosis by tests such as lab work or CT scans, rather than repeatedly treating with antibiotics every time pain is experienced.

Disclaimer: All information provided in this article is for informational purposes only and should not replace the consultative advice and experienced feedback from your physician. Always consult with your physicians on any of your questions and concerns.